New Client Intake Form | LaBarge Weinstein LLP

Name*

Company Name*

Contact Phone Number*

Contact Email

Is your company incorporated?*

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Company Address

Street Address Address Line 2 City Province Postal Code

Brief description of your business

Description of legal advice you are seeking

Do you require assistance with any of the following? Please select all boxes that may apply.

Other

List any other parties that may be involved (e.g. other shareholders, partners, investors, company you are looking to do business with). This is required for conflicts purposes.

How did you hear about us?

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Referral Name

Other

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